Resumo

LOPREITE, Fernando et al. Artroplastia total de cadera en pacientes con artritis reumatoide. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2014, vol.79, n.2, pp.74-81. ISSN 1852-7434.

Background: Fifteen per cent of the patient with osteoarthritis secondary to rheumatoid arthritis will need total hip arthroplasty. The objective is to communicate our experience in total hip arthroplasty in patients with rheumatoid arthritis through a retrospective analysis, emphasizing the alternative prostheses and complications. Methods: Forty eight primary total hip arthroplasties in 40 patients (mean age 58 years), with average 6-year follow-up were analyzed. Twenty three cemented, 21 hybrids and 4 uncemented total hip arthroplasties were performed. Clinical examination with Harris Hip Score, and radiographic studies at 21 and 45 days, 3, 6, and 12 months, and then annually were used for follow-up. We evaluate areas of DeLee-Charnley and Gruen to determine the prosthetic loosening. Results: Average Harris Hip Score was 29.8 before surgery and 82.2 after it. Prosthetic survival reached 98% at 5 years. Eight years after surgery, three additional cases of prosthetic loosening were detected, and prosthetic survival was 87.5% in the medium term. All patients who needed surgical review had cemented implants. There were no signs of radiographic or clinical loosening in the hybrid and non-cemented prostheses. Conclusions: Total hip arthroplasty constitutes a valid procedure that improves the quality of life of patients with rheumatoid arthritis with severe hip compromise. Results depend on several factors, such as type of prosthesis, clinical conditions and surgical technique. As it is published in the international literature, the use of uncemented cups improves prosthetic long-term survival.

Palavras-chave : Rheumatoid arthritis; Total hip arthroplasty; Loosening; Uncemented cups.

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